Employment / FMLA Forms

Request for workplace accommodation under the Americans with Disabilities Act. Triggers the interactive process between employer and employee. Written documentation is recommended though not legally required.

Claim for Paid Family Leave (PFL) Benefits in California. Covers bonding with a new child or caring for a seriously ill family member.

Claim for Disability Insurance (SDI) Benefits. California's State Disability Insurance program for an employee's own medical condition that prevents them from working.

Application for Colorado FAMLI (Family and Medical Leave Insurance). Provides up to 12 weeks of paid leave for medical conditions, bonding, caregiving, or qualifying exigencies.

Application for Paid Family and Medical Leave in Connecticut. Covers medical leave, bonding, caregiving, organ/bone marrow donation, and military qualifying exigencies.

Certification of Health Care Provider for Employee's Serious Health Condition. Medical certification for FMLA leave for the employee's own condition.

Certification of Health Care Provider for Family Member's Serious Health Condition. Medical certification when employee needs leave to care for a family member.

Certification of Qualifying Exigency for Military Family Leave. For leave due to a covered family member's active duty or call to active duty.

Certification for Serious Injury or Illness of Covered Servicemember for Military Family Leave (current servicemember).

Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave.

Designation Notice. Employer designates leave as FMLA-qualifying or denies it. Must be provided within 5 business days of receiving sufficient certification.

Notice of Eligibility and Rights & Responsibilities. Employer must provide within 5 business days of FMLA leave request, stating whether employee is eligible.

Application for Maryland's Family and Medical Leave Insurance program. Covers medical leave, family caregiving, bonding, and qualifying exigencies.

Application for Paid Family and Medical Leave in Massachusetts. Covers medical leave, family leave for bonding or caregiving, and military-related qualifying exigencies.

Medical documentation supporting the need for workplace accommodation. Must describe functional limitations without requiring disclosure of specific diagnosis. Employer must keep confidential.

Application for Temporary Disability Insurance benefits in New Jersey. Provides cash benefits for non-work-related illness or injury preventing employment.

Request for Paid Family Leave in New York. Provides up to 12 weeks of job-protected paid leave to bond with a child, care for a family member, or for a military qualifying exigency.

Application for Paid Leave Oregon. Provides up to 12 weeks of paid leave for medical conditions, family bonding, caregiving, or safe leave purposes.

Certification that employee can return to work, with or without restrictions. Documents functional capacity and any ongoing limitations or accommodations needed.

Generic application for state-level paid family and medical leave programs. As of 2026, 13+ states plus DC have paid family and medical leave programs with their own application forms and certification requirements.

Application for Paid Family and Medical Leave in Washington State. Requires 820 hours worked in WA in the prior year. Accepts FMLA certification forms or other medical documentation.